Individual
SHANNON R GIBBONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, FAAA
Contact information
Practice address
27 HARTFORD TURNPIKE, RT#83, VERNON, CT 06066
(860) 646-7900
(860) 646-7792
Mailing address
8800 SE SUNNYSIDE RD STE 300N, CLACKAMAS, OR 97015-5703
(281) 286-2999
(512) 607-4893
Taxonomy
Speciality
Code
Description
License number
State
237600000X
Audiologist-Hearing Aid Fitter
Primary
000356
CT
237700000X
Hearing Instrument Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D400031083
MEDICARE
CT
Enumeration date
10/23/2006
Last updated
03/17/2018
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